I came across an interesting long term study in Finland on Fibromyalgia spanning 26 years published in the journal of Clinical Rheumatology. Severity of symptoms persists for decades in fibromyalgia-a 26-year follow-up study. There has been this sort of rumour that fibromyalgia improves with time that I have heard several times and so this study is interesting. Also there is this question on whether we can go into remission or not. Either way we all want to know what FM will be like in the future. We know it isn’t progressive but we worry it will worsen with age.
It started with 56 patients in 1986 who were given a base questionnaire. 42 of these fulfilled the criteria for FM at that ime.
Then 26 later 36 of the patients were located again. 28 of these filled out another questionnaire. So we are looking basically at the study of these 28 individuals. Nine of the questions on the new questionnaire were identical to the old one, including questions on quality of life and changes in symptoms.
- Three individuals (11%) had recovered from fibromyalgia. (this is a fascinating number here. Makes you want to dig a little into the reasons for their recovery.)
- 23% reported the remission we hear about, having had one or several symptomless periods lasting at least 1 year. This does suggest that remission is indeed possible.
- In others (n=25), all symptoms aside from pain showed a slight deterioration. So we might see a slight slide in symptoms.
- Despite aging and the FM, functional levels remained the same over time. This is a key one. Functionality, despite aging, remained consistent.
- The actual amount of symptoms reported didn’t change much (10.8 (SD 2.9) vs. 11.1 (SD 4.1), p = 0.75). Symptom changes can lead to a lot of problems, but it looks like over time we do not change overly in them.
- Insomnia showed the most significant increase. I wouldn’t say this is much of a surprise, since it is a difficult one to manage.
- Exercise didn’t have a significant influence on the changes of the measured parameters. But the 3 recovered individuals did exercise on a regular basis. And they speculate since 21 of 24 (who answered the question on exercise) did exercise it might be why functionality was consistent over time. Most of the participants did exercise and this could be then a key to treatment and functionality. A study of those who do not compared to those who do long term would be interesting.
Symptoms of FM have persisted in most patients for decades without significant deterioration of self-reported functional ability. About one fourth of patients had experienced long symptomless periods during their illness. Three patients (11%) reported that they have healed from FM. study
To which we can conclude in the long-term symptoms will remain but there can be extended periods of remission. And that perhaps exercise helps us maintain our current level of functionality over time. This is a positive study for long-term outlook really. At the very least it says things remain consistent over time, not worse.